Depression Relief in the Eye of the Beholder

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Eye movement desensitization and reprocessing (EMDR) may provide additional benefit in the treatment of major depressive disorder (MDD), according to the findings of a small, European, multicenter randomized controlled trial.¹ The research confirms previous studies that show a potential value of EMDR in the management of depression.

The authors argued that the high rate of relapse in depression solely treated nonpharmacologically and persisting challenges related to pharmacologic management necessitate continued search for interventions. In summarizing several studies that showed a strong association between stressful or blatantly traumatic events and risk of depression, the researchers called for heightened exploration of the role of trauma/adversity in the development and progression of MDD. They added that, in light of the current research, complementary desensitizing therapies, namely EMDR, may be of value.

Although the efficacy of EMDR in the treatment of posttraumatic stress disorder has been well researched, its use in depression has only recently begun to receive systematic research attention. The study authors hypothesized that EMDR can provide an additional benefit over treatment as usual (TAU) in patients with acute depressive episodes and that inclusion of EMDR in a treatment regimen can increase the odds of complete remission.

The aim of their study was to replicate previous results showing that EMDR contributes to the improvement of depressive disorders. The total study population was 30 inpatients receiving treatment for a moderate to severe depression. Sixteen patients were relegated to TAU and 14 to TAU + EMDR. TAU consisted of psychodynamic or behavioral group therapy, standard individual therapy, and antidepressant medication. The EMDR + TAU group also received 1 to2 EMDR sessions per week with the goal of processing one memory per week.

It was pointed out that EMDR replaced some of the individual therapy sessions in the EMDR + TAU group (ie, the EMDR + TAU group received fewer individual therapy sessions than the TAU group). Outcomes were evaluated using the Beck Depression Inventory-II (BDI) and the depression subscale of the Symptom-Check-List 90 Items Revised-Version (SCL-90-R). Statistical analysis was by ANCOVA.

A significantly better improvement in BDI scores was seen in the EMDR + TAU group compared with the TAU only group (contrast value = 74.97; P =0.02; ηP2 2; P = .23). Complete remission, per BDI s scores, was achieved in 50% of patients in the EMDR + TAU group compared with 25% in the TAU group. Better outcomes also were seen on the SCL-90-R in the EMDR + TAU group. Mild to clear improvement was noted in 86% of the EMDR +TAU group versus 75% in the TAU only group.

A significant interaction between treatment group and patient age also was found. Lower BDI scores at the study’s conclusion were seen more in older than younger patients in the EMDR + TAU group, but this difference was not seen in the TAU only group. The finding suggests that older patients may benefit more from EMDR treatment than younger ones.

The study authors concluded that, given the high rate of nonresponders to TAU, EMDR may be an adjunctive resource to improve outcomes.

This article was originally posted on 10/16/18 and has since been updated.

References:

1. Hase M, Plagge J, Hase A, et al. Eye movement desensitization and reprocessing versus treatment as usual in the treatment of depression: a randomized-controlled trial. Front Psychol. 2018;14;9:1384.